Abortion clinic escaped scrutiny

By Jodie Snyder,
Heather Ratcliffe and
Susie Steckner
The Arizona Republic
July 17, 1998

The A-Z Women's Health Center, where two women bled to death in the past three years and a full-term baby was almost aborted last month, operated free of scrutiny by state health care officials.

Meanwhile, its two sister clinics in the Valley were checked annually by state investigators for proper equipment and trained staff.

And legislators who this year pushed for more regulation of abortion clinics were assured by state licensing officials that most, if not all, abortion clinics were already regulated.

In fact, of the 14 Valley clinics that advertise abortion services, only six are licensed by the Department of Health Services, according to state records.

This disparity in regulation has angered some lawmakers and left even some state officials confused.

The A-Z center has come under fire because a woman died there in April when her uterus was punctured during an abortion. Another patient died in a similar fashion there in 1995.

On June 30, Dr. John Biskind delivered a full-term baby there that he had started to abort, believing the fetus to be only 23 weeks along.

The A-Z center, which advertises itself as the only Arizona clinic willing to perform riskier late-term abortions, is owned by Dr. Moshe Hachamovitch, a New York doctor.

Hachamovitch is also listed as the chief executive officer for two other Phoenix abortion clinics, the Family Planning Institutes in Phoenix and Tempe.

The A-Z center and most other abortion clinics are not licensed or regulated by the state because they are considered private physicians' offices, said Linda Palmer, DHS deputy assistant director for assurance and licensure services. A facility is considered a doctor's office when it is owned by one or more physicians, and the state can regulate them through their professional licenses, she said.

But Palmer conceded Thursday she couldn't say why the two Family Planning Institutes -- which employ some of the same staff as A-Z -- were licensed. They have been licensed since 1992, when they were owned by another physician.

Over the last five years, inspectors have found problems there ranging from unsterilized equipment to improper paperwork. Neither clinic was fined or penalized, according to DHS records.

Palmer said she was not aware of any licensed abortion clinic being fined or having its license revoked by the state.

Abortion clinics can volunteer to become licensed by the state, which is the case with those operated by Planned Parenthood, Palmer said.

In February, when state legislators were considering tighter regulation over abortion clinics, Palmer told them that DHS already was watching over 10 to 12 clinics, according to an article in Arizona Capitol Times.

Contacted Thursday, Palmer first said she didn't remember what she said in February.

Later she said that the 10-to-12 figure represents the number of Planned Parenthood clinics. Not all of those clinics provide abortion services, though, she said.

The Joint Legislative Budget Committee, a key lawmaking panel, also assured lawmakers that the abortion clinics already were being regulated, but based its analysis on data supplied by DHS, said Jennifer Vermeer, a JLBC analyst.

Now legislators are rethinking the issue of what is a "clinic" and what is a "doctor's office," said Doug Cole, spokesman for House Speaker Jeff Groscost, who was one of the lawmakers seeking greater regulation.

Several legislators have called Groscost's office asking for a closer look into what happened at A-Z, Cole said Thursday. Staffers are looking into more options for more regulation, he added.

Brian McNeil, deputy director of DHS, said Thursday the department isn't eager to regulate more facilities. However, McNeil would not comment on whether he felt abortion clinics should be regulated.

Patients upset with care they receive from the doctors can complain to the agency that licenses the doctor, usually the Arizona Board of Medical Examiners, he said.

However, the medical board, which has been swamped with complaints, is undergoing its own reorganization. Currently, the board has more than 1,100 cases being processed. About a quarter of these have been in the system for more than a year.

The board plans to hold an emergency meeting Monday to consider whether Biskind's license should be suspended because he poses an immediate danger to the public, said Eric Nickell, board ombudsman.

Palmer of DHS said the idea of the state's regulating places according to the type of procedure being done there is a difficult one. It becomes even more difficult, she added, when the procedure is a controversial one such as abortion.

"I don't know if we can come to a common ground very easily on this," Palmer said.

"I realize something wrong is happening at this clinic, but under state statute we are doing what we are told. And right now, the state would have us stay out of it."